Radio interview with Minister Butler and Melinda James, ABC Illawarra – 9 July 2024

MELINDA JAMES, HOST: First, though, let's talk about health. The federal Health Minister, Mark Butler, is in the Shoalhaven today, and he's been good enough to give us a little bit of his time this morning. Minister, Good morning.
 
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Good morning, how are you?
 
JAMES: Yeah, very well, thank you. Why don't you just let us know what you're doing in the Shoalhaven today?
 
BUTLER:  First of all, I’m heading to Batemans Bay to have a look at the Urgent Care Clinic there. It was only opened in December, but already more than 5,000 people have gone through there. It's opened 7 days a week, it's available for walk-in appointments, and importantly, it's fully bulk billed. It's designed really to make sure that people who need urgent care, but not necessarily hospital level care, are able to get it as soon as they possibly can. It’s been really good for kids, frankly. They’re very busy on Saturday afternoon with sporting injuries and kids falling off their skateboard and busting their arms so I’m having a look at that.

I'll also be having a look at the new Headspace in Batemans Bay. This is a service that I've been involved with for probably 15 years, so I'm really excited to look at that. Then we’ll head up the coast, maybe drop in at Ulladulla and then to the endometriosis clinic that we’ve opened in Milton as well for, endometriosis and pelvic pain, so pretty busy.
 
JOURNALIST: Yeah, can I ask in relation to the Urgent Care Clinics, I know it's something that was raised to some weeks ago, but I know that the AMA and the RACGP, so this is the, Royal Australian College of General practice, they have concerns about the lack of evidence that these urgent care centres are doing what they're intended to do. They're rather new. Do we have evidence that they're working in the way they should be in terms of reducing pressure on hospital EDs?
 
BUTLER: You're right, they are rather new. They've been operating for less than 12 months, most of them, and already the network that we promised to build at the last election has seen more than 550,000 patients. The patients that come through there are only able to be seen if they are urgent care. You go to your doctor for your normal vaccination or your diabetes check-up, you won't be seen there, you'll be redirected back to your normal GP, that's the only way they can bill Medicare. But we also know through surveys that the bulk of patients say that if they hadn't been able to get into the Urgent Care Clinic, they would have gone to the local ED. Although it's still relatively new, local hospitals are saying that they're noticing a decline in their less urgent patients, so these are known as non-urgent or semi-urgent presentations. They account for about half of all of the emergency department activity around the country. That's really what we're focusing on for urgent care. As I said, your kid falling off the skateboard or getting an infection that needs to be seen very, very quickly or something in the eye or a deep cut. You know, people are finding it hard to get into their usual GP quickly. So too often, really the only option they have is the local emergency department and we all know not just across Australia but right across the world at the moment with the legacy of COVID, hospital systems are under real pressure.
 
JAMES: So I mean, there has been some criticism from others, including, for example the health director at the Grattan Institute, Peter Breadon, who said that we should really be waiting for the hard data to be released before we start opening more of these so that it isn't a wasted expense. Are you saying that you're satisfied with the data you've seen that has not yet been made publicly available, that these urgent care centres are doing what they're intended to do and are worth the money?
 
BUTLER: They're operating even better than I'd hoped. They're incredibly popular. No one wants to go and see a doctor, but your listeners would know, when it's late at night or it's on Saturday or Sunday, which is about, when about a third of the activity happens on the weekend – if your child needs to see a doctor urgently, you probably almost certainly can't get into your doctor on Saturday afternoon and so instead of waiting, sometimes 8 to 10 hours in an emergency department, people are getting seen very quickly by highly qualified staff and importantly, they are fully bulk billed, so it's completely free of charge. Now, I take the point from the College and the Grattan Institute, this is a new model of care for Australia. It's very common in other countries to have something that sits somewhere between a standard general practice on the one hand, and a fully equipped hospital on the other, to try and take that activity away from the hospital systems that really should be dealing with more once-in-a- lifetime emergencies like heart attacks and strokes and serious accidents. We are going to evaluate it, it's going to be independently evaluated. But there's a huge demand out there, including from state governments. The latest round of new Urgent Care Clinics really came from a meeting that the Prime Minister had with all of the premiers, and they were very keen for an expansion of this service because they know it's relieving pressure on their pretty heavily burdened hospital systems.
 
JAMES: Now, for all of us who just get crook and want to go to the doctor or need to go to hospital, we don't really care where the money comes from or whether or who has responsibility for the services. I know the intersection of responsibilities for health services is pretty complicated, but for us here in the Illawarra, for example, and I do appreciate this is a little outside your portfolio, but I'm sure connected, the pressures on our particular hospital system here in the Illawarra, on our major hospitals, Illawarra, Shoalhaven, etc. We do seem to have, anecdotally, one of the largest number of patients in hospitals unnecessarily waiting for high needs aged care beds. It's an enormous problem here that I hear from individuals and individual families. We're also hearing this morning now about these potential preventable hospitalisations for people needing end-of-life care who might have terminal illnesses, who would be better served getting palliative care outside a hospital setting. It does seem like it's very difficult for hospitals to get about their core business because of some of these issues. I'm wondering where you see your responsibility as the federal Health Minister, most particularly in relation to aged care beds and people who are in hospital unnecessarily waiting for aged care beds?
 
BUTLER: You're right this is something I talk about with my state and territory colleagues quite a lot because I think it is a real challenge to the whole system across the country. Ryan Park, your New South Wales health minister, particularly talks to me about the challenges in the Illawarra region. There does seem to be a higher number of older patients who are stuck in hospitals who are clinically able to be discharged from the hospital if there was somewhere for them to go. That seems to be a particular challenge in the aged care system in the Illawarra with not enough beds and we are working through that with the New South Wales Government. I have departmental officials working with his New South Wales departmental officials on, first of all, trying to shift some capability from outside of the Illawarra, frankly, into the region, because it does have an unusual number of beds that are effectively occupied by what we call long-stay older patients. There is some more work that we are currently doing, not just in the Illawarra but across the system, particularly, as you say, to build the ability for people to have end-of-life care outside of a hospital system. These things are ranked globally pretty frequently, we have one of the 2 or 3 best end-of-life-care systems in Australia, which is ranked independently at a global level. But one of the challenges with our end-of-life system is that about 70% of people die in hospital, and not many people want to die there. They generally want to die at home or in the aged care facility that has become their home in surroundings that are familiar to them, with people around them. We are working hard with state governments to build that capability. In the Budget in May, we put significant additional funds into making sure that people can be palliated in an aged care facility, that they might be with, being put in an ambulance in their end-of-life period and shifted to the local hospital. I'm not going to pretend that this is easy. This is a challenge that is built up over a number of years. It requires governments to work really maturely together, and I think what COVID did teach us as governments at different levels, working through those challenges that you talked about of us having some responsibility and New South Wales Government, having others. There's just a much more mature relationship between levels of government that I remember when I was last in government more than 10 years ago in the health portfolio.
 
JAMES: Mark Butler, I really appreciate your time this morning. Thank you very much.
 
BUTLER: Great to talk to you, see you.
 
JAMES: The federal Health Minister, Mark Butler.